KROGER PHARMACY
NPI 1457385213
Pharmacy - Community/Retail Pharmacy in Ann Arbor, MI

Q: What is Kroger Co Of Michigan's NPI number?

The NPI number for Kroger Co Of Michigan is 1457385213. It was assigned to this organization in the NPPES registry on July 10, 2006. The provider is doing business as Kroger Pharmacy.

Q: What is Kroger Co Of Michigan's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since July 10, 2006CLIA 23D1074854 · Waiver

400 S MAPLE RD, ANN ARBOR, MI 48103(734) 213-2340(734) 213-5361 Get Directions Write a Review

NPPES record last updated: January 25, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 25, 2019, May 16, 2016 (2 updates tracked since 2016).

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About Kroger Pharmacy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KROGER PHARMACY (NPI 1457385213) is a healthcare organization registered as a community/retail pharmacy in Ann Arbor, Michigan and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through October 8, 2027 and lists Jessie Warman, Manager Rx Licensing, as its authorized official.

NPPES Registry Identity

NPI1457385213

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameKROGER CO OF MICHIGAN

Location Address400 S MAPLE RDAnn Arbor, MI 48103-3835

Mailing AddressPo Box 842772Boston, MA 02284-2772 · (513) 762-1019 · Fax (513) 762-1092

Phone(734) 213-2340

Fax(734) 213-5361

Organization SubpartNo

Authorized OfficialJessie WarmanManager Rx Licensing · (513) 762-1090

Enumeration DateJuly 10, 2006

Last NPPES UpdateJanuary 25, 20192 updates tracked since enumeration

✔ NPI 1457385213 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in MI · 5301005207

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

Also ListedPharmacyTaxonomy 333600000X

400 S MAPLE RD, Ann Arbor, MI 48103

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Other Names 1

Doing Business AsKroger Pharmacy

Other Identifiers 2

Medicaid2606374MI

Other2040616Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1074854

Kroger Co Of Michigan, The · Ann Arbor, MI

Active · expires Oct 8, 2027

CLIA Number23D1074854

Laboratory TypeRetail Pharmacy

Certificate Effective DateOctober 9, 2025

Certificate Expiration DateOctober 8, 2027

Laboratory DirectorRobert Brown

Laboratory Phone(734) 213-5434

Laboratory LocationKroger Co Of Michigan, The400 S Maple Road Kroger Pharmacy 018-688 Attn Pharmacist In Charge, Ann Arbor, MI 48103

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

195 services195 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

187 services187 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

31 services30 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

31 services30 patients

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HEIDI LYNN DIEZ PHARM.D.

Pharmacist

400 S MAPLE RD, KROGER PHARMACY ATTN: HEIDI DIEZ
ANN ARBOR, MI 48103

Washtenaw County (734) 213-5343

LAYAL SAM OLLAIK

Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)